Undernutrition in the isolated elderly poor: perspectives from a developing country humanitarian program
Elderly people living in sub-Saharan countries are at risk of undernutrition due to food insecurity, feebleness and for some, abandonment. A cross-sectional community-based survey was conducted on 62 elderly men and women, aged 61-101 years, living in two isolated villages in the rural Ngara District of northwestern Tanzania. All subjects received supplemental food for 21 months prior to the survey from a local humanitarian program, The Village Angels of Tanzania (TVAT). The aim of this study was to compute the nutritional status of the participants using the anthropometric measurements of Body Mass Index (BMI), Mid Upper Arm Circumference (MUAC), and Triceps Skinfold (TSF), and to identify on-going program strategies to address their nutritional needs. SPSS version 24 and basic descriptive statistics were used to analyze all data. Based on the World Health Organization (WHO) accepted ranges for adults, the BMI data showed 53% men and 70% women were in the healthy range, 40% men and 21% women were undernourished, and 7% men and 9% women were mildly overweight. The MUAC cut-off point of ≤ 22.5 cm which corresponds to BMI <18.5 kg/m², the WHO cut-off reference for undernutrition, indicated 87% men and 72% women had both normal muscle mass and subcutaneous fat levels and 13% men and 28% women were undernourished. The TSF figures, also based on WHO ranges, indicated 88% men and 96% women had depleted fat stores and 12% men and 4% women had normal fat stores. Body Mass Index showed strong positive correlations with MUAC (r = 0.75, N = 62, p < 0.001) and with TSF (r = 0.58, N = 62, p < 0.001). The supplemental food likely played a positive role in the healthy weight status (BMI) and normal muscle mass and subcutaneous fat levels (MUAC) of the majority of participants (62%, 80% respectively) but not in their depleted fat stores status (TSF). These findings culminated in recommendations that adroitly targeted newly identified nutritional concerns. Increasing dietary variety, especially meat, fish, vegetables and fruits, and increasing the quantity and nutrient density of a nutritional powder made from stoneground peanuts, soya beans, maize, and millet were two new dietary strategies immediately implemented at the conclusion of the study. Positive TSF trends would support the effectiveness of TVAT’s food delivery program to improve this crucial nutritional parameter for this population.
Keywords: elderly, undernutrition, anthropometric measurements, nutritional status, food program, Tanzania